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Curriculum development for basic gynaecological laparoscopy with comparison of expert trainee opinions; prospective
Christy Burden1, Robert Fox2, Erik Lenguerrand3
1University of Bristol, School of Social and CommunityMedicine, Clinical Research Registrar, Obstetrics and Gynaecology, Gloucester Royal Hospital, Great Western Road, Gloucester, Gloucestershire GL1 3NN, UK; Research into Safety and Quality (RiSQ), Southmead Hospital, Westbury on Trym, Bristol BS10 5NB, UK.
Objective:
To develop content for a basic laparoscopic curriculum in gynaecology.
Study Design:
Prospective cross-sectional observational study. Modified Delphi method with three iterations undertaken by an invited group of national experts across the United Kingdom (UK). Two anonymous online surveys and a final physical group meeting were undertaken. Junior trainees in gynaecology undertook a parallel iteration of the Delphi process for external validation. Population included: expert panel - certified specialists in minimal-access gynaecological surgery, RCOG national senior trainee representatives, and medical educationalists, junior trainees group - regional trainees in gynaecology in first and second year of speciality training.
Results:
Experts (n=37) reached fair to almost complete significant agreement (κ=0.100-0.8159; p<0.05) on eight out of nine questions by the second iteration. Trainees (n=19) agreed with the experts on 89% (51/57) of categories to be included in the curriculum. Findings indicated that 39 categories should be included in the curriculum. Port placement, laparoscopic equipment and patient selection were ranked the most important theoretical categories. Hand-eye co-ordination, camera navigation and entry techniques were deemed the most valuable skills. Diagnostic laparoscopy, laparoscopic sterilisation, and laparoscopic salpingectomy were the operations agreed to be most important for inclusion. Simulation training was agreed as the method of skill development. The expert panel favoured box trainers, whereas the junior trainee group preferred virtual reality simulators. A basic simulation laparoscopic hand-eye co-ordination test was proposed as a final assessment of competence in the curriculum.
Conclusion:
Consensus was achieved on the content of a basic laparoscopic curriculum in gynaecology, in a cost- and time-effective, scientific process. The Delphi method provided a simple, structured consumer approach to curriculum development that combined views of trainers and trainees that could be used to develop curricula in other areas of post-graduate education.
